Coital Headache

Headache during sex

by Garrett
(Alabama)

Sex Headaches

I am a 21 year old male, who about 3 years ago had sex and started to have extremely painful headaches, that is pounding and its deep into my neck and all over my head. The headache starts soon after sex and gets really intense at the orgasm. It usually leaves me laying in bed curled up in pain. It seems to happen to my pretty randomly every year since but it seems to never go away for over a week to two weeks at a time.

My question is what is causing this and what can I do to fix my problem? I have tried taking advil, tylenol, and excedrine migraine, and nothing seems to be working.

Garrett

Answer:

Hi Garrett,

Your problem of headache during sex is more common than you think.

The technical term is benign coital headache but if it lasts for several days afterward it may be triggering a migraine headaches. Migraines that go beyond three days are termed status migrainosus.

I would like you to read this page about headache during sex. If you have not seen a neurologist about this, I would recommend you make an appointment to have an MRI and MRA done to rule out an aneurysm.

You do not mention if there is a family history of headaches, migraines or aneurysms. If there is make sure you tell the doctor this as migraine and aneurysms can be passed genetically in a family.

If aneurysm is ruled out the treatment is simple..an anti-inflammatory taken about an hour before sexual relations.

Good luck!
Mary Kay Betz MS RPA-C
Physician Assistant

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Coital Headache

by Lee
(Panama City, FL)

I experienced a sudden, severe, throbbing headache...right side of head shortly after beginning sex with my wife...this was about a month and a half ago. A week later it happened again while wrestling with my son...though it wasn't as severe. A week later it starts up again with coughing, sneezing, lifting...any exertion...even mild exertion such as pushing and pulling. Now it seems to start for no apparent reason.

Have had Mra and Mri and Eeg...all normal. Dr says they are migraines, but I am 42 with no family history and it just doesn't add up to me. Another symptom..not sure if it is related...certain foods now taste so incredibly salty, where they haven't before.

Last night it started again with sex...not at orgasm, but within a few minutes of beginning. I went to bed and 4 hours later it is still hurting...went back to sleep and woke up with a nose bleed. (not sure if this is significant, have had nose bleeds all my life on and off) Have had normal blood pressure readings, although a few readings taken at home have been high. Just wondering what to pursue now. Any advice?? Thank you in advance.

Lee

Answer

Hi Lee,

I have heard this complaint before..in fact just heard it from a patient yesterday. The official term for this type of headache is benign coital headache or a headache during sex.

I am glad that you had an MRI and MRA as there have been times when we image people for this problem and we find aneurysms. That is what the doctor was looking for.

Benign coital headache does indeed lead to a migraine but it can be treated. Benign cough headaches are very similar in pain. Many times I will have someone try naprosyn 500mg an hour or two before relations and you could try Aleve which is the over the counter form of naprosyn. Ibuprofen or tylenol do not work as well.

Another option is to go on low dose propranolol which is a beta blocker in the anti-hypertensive class. This has been shown to be quite effective for this headache and for exercise induced migraines. By the way, you do not have to have a family history of migraine to get them, just that most of the time people do have this history. Migraines can also crop up at any time in a person's life. We see people in their 60's and 70's who never had a problem and then all of a sudden start having pain.

As an additional preventative, you could consider magnesium which has worked well for many people. Give it a good 90 days before deciding if it is working. During this time you might also consider keeping a headache diary to see if treatments are working.

As long as your blood pressure is under control and you have no other cardiovascular risks you should be able to take a triptan such as Imitrex once the headache starts.

Talk to your doctor about treatment as more than 1-2 unmanaged migraines per year can increase someone's risk of stroke as they age.

Good luck!
Mary Kay Betz MS RPA-C

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Does the scenerio above sound like you? If not, or if you think you need more information please read about different types of headaches to find out which type of headache you are experiencing.

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